FRED EUGENE BURKHARDT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019011410

License Status

NOT RENEWED

Business

First Name

FRED

Middle

EUGENE

Last Name

BURKHARDT

Suffix

DDS

Business Name

FRED EUGENE BURKHARDT DDS

Original Issue Date

11/05/1958

Effective Date

08/23/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60634

County

COOK

Ever Disciplined

LastModifiedDate

02/08/2016